What Does a Medical Billing Clerk Do?

A description of medical billing clerk job responsibilities and how to kick-start your career from this position.

Once you begin searching for jobs in the medical billing and coding field, you may be overwhelmed by the different terms used for medical billing personnel.

You may find yourself asking...

What is a medical billing specialist?

What does it mean to be certified?

What are the responsibilities of a billing account manager?

What does an A/R Specialist do?

What is a billing and insurance coordinator?

What is a medical billing clerk?

While the job titles may differ, their responsibilities remain similar.

There'll always be a need for qualified individuals to code, send, and follow up on health insurance claims. There's also a strong need for someone to fill out all of the other necessary claims paperwork, making sure that the doctor and his or her staff get paid.

These jobs range from high-level jobs, such as billing manager, office manager, and accounts manager, down to medical billing/coding specialists, insurance coordinator... and medical billing clerk.

How do you get it?

Because a billing clerk is an entry level position it doesn't require many qualifications. The employer posting a medical billing clerk position usually wants little more than a high school diploma or GED, and possibly one to two years of medical office experience.

Your employer may actually teach you the office procedures and practice management software, as well as the basics of medical billing.

If you're still in medical billing or coding school, you may be a desirable candidate for a billing clerk position.

On the other hand, because the medical billing clerk position is entry-level and doesn't have many requirements, the pay is much less than a more qualified job.

What does a medical billing clerk do?

Although a clerk position is entry-level, it doesn't mean that there isn't much responsibility.

A clerk does all the little things needed to keep the billing and insurance office running smoothly. This includes:

making billing and insurance phone calls

working easy claims

performing regular office duties

As a clerk you'll be directly under the medical billing specialist or billing and accounts manager. Your supervisor will assign you daily duties as well as give you miscellaneous tasks to help with the billing process for the entire office.

Usually, the billing clerk has to work easy claim denials. These are ones that were denied, for example, because they got sent to the wrong insurance company.

In this case, you'd have to find the correct patient insurance information, verify the patient's eligibility with the insurance plan, and refile the claim to the correct plan.

Similarly, you may be responsible for sending corrected claims. These are claims that were denied because...

they didn't have a modifier

the subscriber identification number wasn't found

the subscriber group identification number was incorrect or missing

or for a number of other easy missteps.

There are also lots miscellaneous claims cleanup duties that you might have to perform as a medical billing clerk. Examples include following up on old claims,calling insurance companies to see if they've processed a claim yet, or to see why a particular claim or line item was denied.

As a clerk, you'll also perform miscellaneous office duties, and may be required to fill in as needed as part of the front office staff. This means that you may have to work as a receptionist or front office assistant if necessary.

Further duties include:

answering billing phone calls

collecting patient payments on balances

organizing and managing files.

All in all, the medical billing clerk position is a big responsibility. You're helping complete the billing process in your office, making sure everyone gets paid.

If you can show your employer that you're good at what you do and show potential to learn new things, you may be able to move up the ladder to a higher-level medical billing position.

How do you climb the ladder?

It's easier to get a higher paid job as your experience and education in medical billing grows. Getting your certification in medical billing will also help immensely.

Just as in most office settings, the best way to work up the ladder is to show that you are a loyal, committed, and hard-working employee.

In the medical billing profession especially, you have to show a willingness to learn new things and help make the billing process easier for everyone.

Make an effort to work smarter, not harder. This shows your supervisor that you're an asset to the medical billing team, and if you get promoted you could help the medical billing staff on a higher level.

Diagnosis/procedures codes and medical billing guidelines are always changing - you should constantly reevaluate your processes. Try to see if you can make changes in your office that will help make everyone's job easier.

Don't be afraid to take on new responsibilities and learn new things, such as:

how patient accounts work

how to transfer patient balances or credits

how to make the recoupment process easier.

Ask questions beyond your position - be genuinely curious and interested. As you become more knowledgeable, use it for advancement in your company, as well as to help you in your daily duties.

And finally, help out whenever and wherever you can - don't let you billing clerk job title hold you down. No matter what job position you hold, you can make yourself as valuable an asset to your team as any high-level member.

Remember, no-one starts out at the top. At some point, they were all medical billing clerks.